AB0255 CORRELATION BETWEEN PATIENT GLOBAL ASSESSMENT AND DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS: ANY CHANGE OVER TIME?
Authors: A. Fazaa, H. Boussaa, K. Ouenniche, S. Miladi, M. Yasmine, L. Souabni, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patient-reported outcomes (PROs) such as the Patient Global Assessment (PGA) are included in the definition of disease activity in rheumatoid arthritis (RA). Major determinants of the PGA are pain severity, functional limitations and fatigue. In contrast, the correlation with more objective measures of inflammation is weaker. In the early stages of the disease, the PGA might in theory more strictly reflect the patient's perception of inflammation. <h3>Objectives</h3> The aim of this study was to investigate the correlations between the PGA and disease parameters in patients with RA over time. <h3>Methods</h3> We conducted a prospective study including patients with RA (ACR/EULAR 2010). Demographic data and the following disease parameters were collected at inclusion and at 12 months follow-up: PGA, pain Visual Analog Scale (VAS), tender joint count (TJC), swollen joint count (SJC), Erythrocyte Sedimentation Rate (ESR), C Protein Reactive (CRP), Disease Activity Score 28 (DAS28), and Health Assessment Questionnaire (HAQ). Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) which is a short 13-item questionnaire validated in RA. The score FACIT-F ranges between 0 and 52. Fatigue was considered mild if the FACIT-F score was ≥40, moderate if 20≤FACIT-F&lt;40 and severe if 0≤FACIT-F&lt;20. A <i>p</i> value inferior to 0.05 was considered significant. <h3>Results</h3> We included 100 RA patients (84 women and 16 men) with a mean age of 49.5±10 years old [18-65]. The mean disease duration was 87.3 months [1-360]. Rheumatoid Factor (RF) and Anti-Citrullinated Protein Antibodies (ACPA) were positive in 75% and 72.6%, respectively. At inclusion, the mean PGA was 47.8 cm [0-100] and the mean pain VAS was 49 cm [0-100]. The mean TJC and SJC were 5.3 [0-36] and 1 [0-9], respectively. The mean levels of ESR and CRP were 38.1 mm [10-120] and 10.8 mg/l [2-61], respectively. The mean DAS28 ESR was 3.68 [1.90-8.33] and the mean HAQ score was 0.9 [0-2.75]. The mean FACIT-F score was 27.1 [0-51] in RA patients versus 46.2 [0-52] in healthy controls (p&lt;0.001). Among RA patients, 57% had moderate fatigue and 26% had severe fatigue. A significant positive correlation was noted between PGA and, TJC (r=0.508, p&lt;0.001), SJC (r=0.331, p=0.001), pain VAS (r=0.763, p&lt;0.001), ESR (r=0.364, p&lt;0.001), DAS28 ESR (p=0.743, p&lt;0.001) and HAQ (r=0.660, p&lt;0.001). A significant negative correlation was noted between GPA and FACIT-F score (r=-0.658, p&lt;0.001). At 12 months follow-up, the correlations became stronger between PGA and, TJC (r=0.664, p&lt;0.001), SJC (r=0.673, p&lt;0.001), pain VAS (r=0.893, p&lt;0.001), ESR (r=0.536, p&lt;0.001), DAS28 ESR (p=0.867, p&lt;0.001), HAQ (r=0.686, p&lt;0.001), and FACIT-F score (r=-0,792, p&lt;0.001). A positive correlation was also noted between PGA and disease duration (r=0.205, p=0.045). <h3>Conclusion</h3> Disease activity, functional limitation, pain and fatigue directly correlate with PGA. This relation seems to strengthen over time as RA patients gain the ability to better understand and assess their illness. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.